Risk factors associated with adverse events in neonates with peripherally inserted central catheter

Abstract

BackgroundPeripherally inserted central catheters have become a priority in infants who require long-term intravenous therapy, but their use involves certain risks. ObjectiveThe aim of the study was to describe the occurrence of adverse events in newborns with peripherally inserted central catheters and to determine the risk factors associated with them. MethodsA descriptive cross-sectional study was designed and performed. All neonates with peripherally inserted central catheters from October 1st, 2014 to September 30th, 2015 were included. The adverse events and sociodemographic and clinical variables related to neonates and analysed catheters were recorded. ResultsA total of 140 catheters were placed in 116 infants. All of them were analysed. Adverse events occurred in 16.4%: catheter-associated bacteraemia (5.7%), obstruction (5.7%), extravasation (2.1%) and phlebitis (2.1%), <27 weeks of pregnancy (OR=1.2, p=.02), birth weight <1000g (OR=6.7, p=.02), with catheters in situ for longer than one week (OR=9.8, p=.02) and with perfusion of antibiotics per catheter (OR=1.3, p<.01). Phlebitis is associated with the insertion of the catheter in LL and head (OR=1.1, p=.03). Factors associated with bacteraemia risk with adjusted prevalence odds ratio are extremely low birth weight neonates (OR=6.38; p=.03) and with a catheter in situ for longer than one week (OR=9.41; p=.04). ConclusionsThe periodic evaluation of catheter-related adverse events is very useful to prepare improvement plans. This will maximise safety for the most vulnerable newborns, especially those of extremely low birth weight that require very long treatments.